Digestive Disorders / Gastroenterology Expert Forum
Risk of Cancer
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This is a place to ask questions about digestive problems and receive a personal answer from a highly qualified doctor. You will also find support from other members who share your interest in digestive disorders. Digestive Disorders include: Anal and Rectal problems, Barrett’s Esophagus, Bleeding in the Stomach and Digestive Tract, Constipation, Crohn’s Disease, Gastritis, GERD, Heartburn, Proctitis, Short Bowel Syndrome, Ulcers, Whipple’s Disease, Zollinger-Ellison Syndrome (and many more).

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Risk of Cancer

I underwent a standard endoscopy (including colonoscopy)and the following were the findings from it and the histopathy:

(1) mild erythema conssistent with Grade 1 gastro-oesophageal reflux disease;
(2) mild antral gastrities, clo test negative, rest of stomach and duodenum normal;
(3) two rectal polyps (both of them showing predominantly low grade dysplassia) representing a villous adenoma with low grade dysplasia and a tubulovillous adenoma with high grade dysplasia found focally in it. Rest of colon to caecum noted to be normal. The two polyps were completely snared and retrieved.

What is the risk and time frame of the possibility of my getting colorectal cancer and/or gastro-oesophageal cancer? What kind of lifestyle and food habits I should adopt to minimise the risk?
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Of the polyps removed, the villous adenoma with high grade dysplasia is most at risk for developing into cancer - with up to 30 percent becoming cancerous.  

Appropriate followup would depend on the size of the polyp removed.  Since there were villous adenomas found, guidelines would recommend a repeat colonoscopy in 3 years.  

Regarding the upper endoscopy - there is no consensus as to how often to screen for Barrett's esophagus or esophageal cancer in chronic GERD patients.  

I would discuss these options with your gastroenterologist.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
1 Comment
Regarding the GERD/Barrett's screening, if you have made the appropriate lifestyle changes and annual endoscopies show the Barrett's to be stable after three to five years of surviellance, you can probably go to an endoscopy every five years.  However, if you notice any changes in your ability to swallow, you should schedule another andoscopy as soon as possible.

Good luck,
Chicken Soup
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